Ulnar Neuropathy (Cubital Tunnel Syndrome)
What is Ulnar Neuropathy?
Ulnar Neuropathy occurs when the ulnar nerve becomes compressed, most commonly at the elbow (cubital tunnel syndrome), although it can also be affected at the wrist.
The ulnar nerve supplies sensation to the little finger and part of the ring finger and controls many of the small muscles in the hand.
Symptoms may include:
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Numbness or tingling in the little and ring fingers
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Symptoms that worsen when the elbow is bent
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Weakness of grip
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Difficulty with fine finger movements
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Hand muscle wasting in more severe cases
Common causes include prolonged leaning on the elbows, repeated elbow bending, or pressure on the nerve during sleep.
Why Have I Been Referred for Nerve Conduction Studies (NCS) and Electromyography (EMG)?
Your doctor may have recommended these tests to:
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Confirm whether your symptoms are due to ulnar nerve compression
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Determine whether the nerve is affected at the elbow or wrist
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Assess the severity of nerve damage
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Exclude other conditions such as cervical radiculopathy or peripheral neuropathy
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Help guide treatment decisions, including whether surgery may be beneficial
Nerve conduction studies are the most reliable way to confirm and localise ulnar neuropathy.
What to Expect During the Test
Nerve Conduction Studies (NCS): Electrodes are placed on the skin over the hand and arm. Mild electrical pulses are used to stimulate the ulnar nerve and measure how quickly signals travel across the elbow and wrist.
Electromyography (EMG): EMG is not always required but may be recommended if there is significant weakness or concern about more widespread nerve involvement. A very fine, disposable sterile needle is inserted into selected muscles to assess their electrical activity.
For further information on NCS/EMG, please visit our information page here.
Summary
Ulnar neuropathy is a common and treatable condition caused by compression of the ulnar nerve, most often at the elbow, and less commonly, at the wrist. Symptoms typically include numbness in the little and ring fingers, and hand weakness. NCS and EMG are safe, specialised tests that confirm the diagnosis, assess severity, and guide treatment, which may include activity modification, splinting, or surgery.